Maternal mortality in Utah.
OBJECTIVE
To determine trends in maternal deaths in Utah, identify opportunities for preventive intervention, and analyze the mechanism of reporting maternal deaths.


METHODS
A retrospective review was performed of maternal death certificates and medical records in Utah from January 1, 1982, through December 31, 1994.


RESULTS
Sixty-two maternal deaths were identified. The risk of maternal death increased with maternal age and parity. The classic triad of hemorrhage (n = 8), infection (n = 5), and preeclampsia-eclampsia (n = 3) remains an important contributor (16 of 62 or 25.8%). However, trauma (n = 10), pulmonary embolism (n = 10), and maternal cardiac disease (n = 9) now account for 46.8% (29 of 62) of maternal deaths. A greater number of direct obstetric causes of maternal death (n = 20) were deemed preventable than indirect obstetric causes (n = 1) or nonobstetric causes (n = 4).


CONCLUSIONS
Trauma, pulmonary embolism, and maternal cardiac disease have emerged as the most common identifiable causes of maternal death. Improvements in prevention, earlier diagnosis, and aggressive treatment of these conditions are necessary to achieve the Public Health Service year 2000 objective of a 50% reduction in maternal mortality ratios (using the 1987 ratio as a baseline).
Jacob
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S
Department of Obstetrics and Gynecology, University of Utah School of Medicine and Utah Department of Health, Salt Lake City 84132, USA.
Bloebaum
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Shah
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Varner
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MW
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D011247:Pregnancy; D014589:Utah / Q000453:epidemiology